Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2008
Randomized Controlled Trial Comparative StudyNeuropsychologic and quality-of-life outcomes after coronary artery bypass surgery with and without cardiopulmonary bypass: a prospective randomized trial.
The objective of this study was to compare neuropsychologic and quality-of-life outcomes of patients undergoing off-pump coronary artery bypass surgery to those undergoing coronary artery bypass graft surgery using conventional cardiopulmonary bypass. ⋯ Patients receiving coronary artery bypass grafts without cardiopulmonary bypass did not show fewer cognitive deficits or greater improvement in quality of life.
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J. Cardiothorac. Vasc. Anesth. · Aug 2008
Comparative StudyPredictors and early and late outcomes of dialysis-dependent patients in contemporary cardiac surgery.
The aim of the study was to investigate the incidence and predictors of renal failure requiring dialysis (RF-D) in a contemporary cohort of patients undergoing cardiac surgery. The authors also analyzed early and late outcome of patients with this complication. ⋯ The authors observed an increase in the overall incidence of RF-D compared with previous studies, probably related to an increased prevalence of patients undergoing more complex procedures with a worsening risk profile. Postoperative RF-D was not only associated with increased hospital mortality and morbidity, but also with a significant reduction of long-term survival in discharged patients. Seven independent predictors of RF-D were identified. Future research efforts should focus on a more precise identification of patients at risk and the development of new treatment modalities, which would potentially prevent the occurrence of this complication.
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J. Cardiothorac. Vasc. Anesth. · Aug 2008
Comparative StudyReactive oxygen species and mitochondrial adenosine triphosphate-regulated potassium channels mediate helium-induced preconditioning against myocardial infarction in vivo.
Helium produces preconditioning by activating prosurvival kinases, but the roles of reactive oxygen species (ROS) or mitochondrial adenosine triphosphate-regulated potassium (K(ATP)) channels in this process are unknown. The authors tested the hypothesis that ROS and mitochondrial K(ATP) channels mediate helium-induced preconditioning in vivo. ⋯ The results suggest that ROS and mitochondrial K(ATP) channels mediate helium-induced preconditioning in vivo.
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J. Cardiothorac. Vasc. Anesth. · Aug 2008
Comparative StudyRisk factors for failed "fast-tracking" after cardiac surgery in patients older than 70 years.
"Fast-track" pathways have been successfully used in low-risk, relatively young patients after all types of surgical procedures including cardiac surgery. An increase in the number of referrals of older patients for cardiac surgery prompted the present study on the use of a "fast-track" pathway in septuagenarians and octogenarians. Risk factors for the unsuccessful application of the "fast-track" pathway in these elderly patients were determined. ⋯ A "fast-track" pathway may be applied in selected septuagenarians and octogenarians. Age alone should not exclude consideration for "fast-track" management.